VSP is the largest vision insurance provider in the US. You have access to a large network of eye care professionals that spans Ophthalmology and Optometry. Having worked as a provider for more than 10 years, I'm going to share a few tips with you to maximise your benefits.
Stay In-Network
There is no better way to start maximising your benefits then by going to an in-network provider. VSP makes it easy with their online search tool found here. You can search based on your Zip code and you can even select the services that matter to you such as language, frame brands and type of doctor. It's really easy to find your perfect in-network provider.
Go Premier
Though any in-network provider is great, there are some that are defined as "Premier". Providers must meet certain requirements in order to acquire this title. Here are a few of those services:
Wide selection of featured frame brands
Performance Lenses
Preventative eye health and wellness program participant
Advanced eye exam technology
Available to all VSP members
I don't want to discourage you from seeing a non-premier doctor but there are clearly some incentives for going Premier.
Understand Your Benefits
VSP typically breaks your benefits up into 4-5 services
Exam
Frame
Lenses
Contact Lenses
Contact Lens Exam
The Exam(s) benefit is independent of the material benefits and you are not obligated to use your material benefits at the same location where you had your exam.
The material benefits (Frame, Lens and Contact Lens) are split up. Even when all your material benefits are available you must choose between glasses or contacts. There are some plans that give members multiple material benefits; this is the only way VSP will contribute towards both glasses and contacts.
If you elect to go with your contact lens benefit then you'll effectively be exhausting all of your material benefits. For example, let's say you have a $150 contact lens allowance; if you choose to put that towards your contact lens order then you will not have any benefits to go towards glasses. Even if your order is only partially using the allotted amount, it must always go towards contacts.
This isn't a problem as long as you don't need contacts and glasses. If you need both, then it's advantageous to put your material benefits towards glasses. Contacts are generally considered cosmetic whereas glasses are considered medically necessary.
Know Your Reactivation Cycle
It's important to know when your benefits will kick back in after you use them because there are a few different ways that it works.
Reactivation based on Service Date
Reactivation based on Calendar Year
Reactivation based on preset month
Reactivation based on Service Date
If you use your benefits in October of 2019, you'll get the benefit back October of 2020 or 2021. The amount of time you have to wait depends on the contracted terms that you or your employer established with VSP.
Reactivation based on Calendar Year
If you use your benefit December of 2019, you'll get the benefit back January or 2020 or 2021. This is a "use it or lose it" type of benefit so make sure to use what you're entitled to. Keep in mind that your benefit may renew every January but that could mean next January or every other January.
Reactivation based on preset month
Similar to the Calendar year cycle, some VSP plans reactivate benefits on a set month of the year. This could be June, October or any other month. This is especially common for individuals that enrolled on their own. Just like all the other types of plans, the reactivation can happen the next time the preset month occurs or every other time that month occurs.
In Conclusion:
It can be a bit confusing but you're provider should have no problem explaining it to you in person. Maximising the benefit could mean one thing for John and something else for Jane. Your provider should take your unique situation into account and suggest the best way to move forward based on your needs.
I hope this helps. Have an awesome day.
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